(1-4) (5-10) - wisconsin · 2018-11-02 · 1. owis of 3 or more that occurred in the last 5 years...

Wisconsin Department of Safety and Professional Services Division of Policy Development

4822 Madison Yards Way, 2nd Floor

PO Box 8366 Madison WI 53708-8366

Phone: 608-266-2112

Web: http://dsps.wi.gov

Email: [email protected]

Scott Walker, Governor

Laura Gutiérrez, Secretary

BOARD OF NURSING

Room N208, 4822 Madison Yards Way, 2nd Floor, Madison

Contact: Brittany Lewin (608) 266-2112

November 8, 2018

The following agenda describes the issues that the Board plans to consider at the meeting. At the time

of the meeting, items may be removed from the agenda. Please consult the meeting minutes for a record

of the actions of the Board.

AGENDA

9:00 A.M.

OR IMMEDIATELY FOLLOWING THE NURSE PRACTICE ACT (NPA) EDUCATION

WORKGROUP MEETING

OPEN SESSION – CALL TO ORDER – ROLL CALL

A. Adoption of Agenda (1-4)

B. Approval of Minutes of October 11, 2018 (5-10)

C. Administrative Matters – Discussion and Consideration

1. Board Members – Term Expiration Dates:

a. Paul Abegglen – 7/1/2019

b. Rosemary Dolatowski – 7/1/2022 (appointed, not yet confirmed)

c. Jennifer Eklof – 7/1/2021

d. Elizabeth Smith Houskamp – 7/1/2020

e. Peter Kallio – 7/1/2022

f. Sheryl Krause – 7/1/2018

g. Lillian Nolan – 7/1/2019

h. Luann Skarlupka – 7/1/2021

i. Pamela White – 7/1/2019

2. Department Updates

3. Appointment of Liaisons and Alternates

D. Education and Examination Matters – Discussion and Consideration

1. Lakeshore Technical College – Practical Nursing (PN) School Approval (11-43)

E. Legislative and Administrative Rule Matters – Discussion and Consideration (44-49) 1. Act 108 Report – Review of Chapters N 2 and 4

2. Updates on Legislation and Pending or Possible Rulemaking Projects

1

http://dsps.wi.gov/

mailto:[email protected]

F. Speaking Engagement(s), Travel, or Public Relation Request(s) – Discussion and

Consideration

1. Travel Report: Sheryl Krause and Beth Smith-Houskamp – 2018 NCSBN Scientific Symposium

in Chicago, IL on October 24 & 25, 2018

2. Travel Report: Jennifer Eklof – NCLEX Item Review on October 22, 2018

G. National Council of State Boards of Nursing (NCSBN) Items – Discussion and Consideration

1. Nurse Practice Act (NPA) Education Workgroup Update

H. Board of Nursing Liaison Reports – Discussion and Consideration

I. Deliberation on Items Added After Preparation of Agenda:

1. Introductions, Announcements and Recognition

2. Election of Officers

3. Appointment of Liaisons and Alternates

4. Delegation of Authorities

5. Administrative Matters

6. Education and Examination Matters

7. Credentialing Matters

8. Practice Matters

9. Legislative and Administrative Rule Matters

10. Liaison Reports

11. Board Liaison Training and Appointment of Mentors

12. Informational Items

13. DLSC Matters

14. Presentations of Petitions for Summary Suspension

15. Petitions for Designation of Hearing Examiner

16. Presentation of Proposed Stipulations, Final Decisions and Orders

17. Presentation of Proposed Final Decision and Orders

18. Presentation of Interim Orders

19. Petitions for Re-Hearing

20. Petitions for Assessments

21. Petitions to Vacate Orders

22. Requests for Disciplinary Proceeding Presentations

23. Motions

24. Petitions

25. Appearances from Requests Received or Renewed

26. Speaking Engagement(s), Travel, or Public Relation Request(s)

J. Public Comments

CONVENE TO CLOSED SESSION to deliberate on cases following hearing (s. 19.85(1)(a),

Stats.); to consider licensure or certification of individuals (s. 19.85(1)(b), Stats.); to consider

closing disciplinary investigations with administrative warnings (ss. 19.85 (1)(b), and 440.205,

Stats.); to consider individual histories or disciplinary data (s. 19.85 (1)(f), Stats.); and to confer

with legal counsel (s. 19.85(1)(g), Stats.).

K. Credentialing Matters

1. Application Review

a. David Lenninger – R.N. & A.P.N.P Renewal Applicant (50-77)

b. Holly Moeller – L.P.N. Applicant (78-99)

c. Erika Palomino – R.N. Applicant (100-113)

2

L. Deliberation on DLSC Matters

1. Attorney Elizabeth Bronson

a. Stipulations and Final Decisions and Orders

1. 17 NUR 452 – Carol P. Jeuck (114-121)

2. Attorney Alicia Kennedy


1. 17 NUR 357 – Angela R. Buss-Espinoza, R.N. (122-127)

2. 17 NUR 447 – Ian W. Cummins, R.N. (128-134)

3. 17 NUR 635 – Zita M. Cooper, L.P.N. (135-140)

4. 18 NUR 067 – Jonathan L. Long, R.N. (141-146)

3. Attorney Lesley McKinney


1. 17 NUR 168 – Casey I. Kirchman, R.N. (147-153)

2. 17 NUR 482 – Kristine M. Disrud, R.N. (154-159)

4. Attorney Zachary Peters

a. Administrative Warnings

1. 16 NUR 749 – S.M.B. (160-161)

5. Monitoring (162-163)

a. Department Monitor Erin Graf

1. APPEARANCE: Susan Thiel, R.N. – Requesting Access to Controlled Substances and

Reduction in AA/NA Meetings (164-191) 2. Kimberly Anderson, R.N. – Requesting Ability to Pass Narcotics in NICU and Reduction

in Screens (192-229)

3. Renee Bender, R.N. – Requesting Full Licensure (230-267)

4. Heidi Hargis, R.N. – Requesting Full Licensure (268-308) 5. Mark Knogshaug, R.N. – Requesting Ability to Work in Home Health and Public Health,

Termination of Direct Supervision and Reduction of AA/NA to Once Per Week (309-

339)

b. Department Monitor Jesse Benisch

1. Elizabeth Watts, R.N. – Requesting Full Licensure (340-357)

c. Department Monitor – Zoua Cha

1. Kimberly Hughes, L.P.N. – Requesting Full Licensure (358-376)

2. Heather Pierce, R.N. – Requesting Full Licensure (377-411)

3. Justine Schneider, R.N. – Violation of Board Order (412-448)

6. Case Closings (449)

M. Deliberation of Items Added After Preparation of the Agenda

1. Education and Examination Matters

2. Credentialing Matters

3. DLSC Matters

4. Monitoring Matters

5. Professional Assistance Procedure (PAP) Matters

6. Petitions for Summary Suspensions

7. Petitions for Designation of Hearing Examiner

8. Proposed Stipulations, Final Decisions and Order

9. Administrative Warnings

3

10. Review of Administrative Warnings

11. Proposed Final Decision and Orders

12. Matters Relating to Costs/ Orders Fixing Costs

13. Case Closings

14. Board Liaison Training

15. Proposed Interim Orders

16. Petitions for Assessments and Evaluations

17. Petitions to Vacate Orders

18. Remedial Education Cases

19. Motions

20. Petitions for Re-Hearing

21. Appearances from Requests Received or Renewed

N. Consulting with Legal Counsel

RECONVENE TO OPEN SESSION IMMEDIATELY FOLLOWING CLOSED SESSION

O. Vote on Items Considered or Deliberated Upon in Closed Session, if Voting is Appropriate

P. Board Meeting Process (Time Allocation, Agenda Items) – Discussion and Consideration

1. Newsletter Planning

Q. Board Strategic Planning and its Mission, Vision and Values – Discussion and Consideration

ADJOURNMENT

NEXT MEETING DATE: DECEMBER 13, 2018

************************************************************************************

MEETINGS AND HEARINGS ARE OPEN TO THE PUBLIC, AND MAY BE CANCELLED

WITHOUT NOTICE.

Times listed for meeting items are approximate and depend on the length of discussion and voting. All meetings

are held at 4822 Madison Yards Way, 2nd Floor, Madison, Wisconsin, unless otherwise noted. In order to confirm

a meeting or to request a complete copy of the board’s agenda, please call the listed contact person. The board may

also consider materials or items filed after the transmission of this notice. Times listed for the commencement of

disciplinary hearings may be changed by the examiner for the convenience of the parties. Interpreters for the hearing

impaired provided upon request by contacting the Affirmative Action Officer, 608-266-2112.

4

BOARD OF NURSING

MEETING MINUTES

OCTOBER 11, 2018

PRESENT: Paul Abegglen, Rosemary Dolatowski, Jennifer Eklof, Peter Kallio, Lillian Nolan,

Luann Skarlupka, Elizabeth Smith-Houskamp, Pamela White

EXCUSED: Sheryl Krause

STAFF: Brittany Lewin, Division Administrator; Colleen Meloy, Legal Counsel; Sharon

Henes, Administrative Rules Coordinator; Kimberly Wood, Program Assistant

Supervisor-Adv.; and other DSPS Staff

CALL TO ORDER

Peter Kallio, Vice Chair, called the meeting to order at 8:08 a.m. A quorum of eight (8) members

was confirmed.

ADOPTION OF THE AGENDA

Amendments to the Agenda

• Closed Session: Under item “N. Deliberation on DLSC Matters; 1. Attorney Alicia Kennedy;

b. Stipulations and Final Decisions and Orders” ADD:

o 16 NUR 638 – Andrea R. Elverman, L.P.N.

• Closed Session: Under item “N. Deliberation on DLSC Matters; 2. Monitoring; b.

Department Monitor – Zoua Cha” correct the request of Karleen Delikowski, R.N. to

“Requesting a Reduction in Drug Screens and Access to Controlled Substances”

• Under item “D. Administrative Matters; 1. Board Members – Term Expiration Dates; Update

the status of Rosemary Dolatowski to include “(Appointed, not yet confirmed)”

MOTION: Pamela White moved, seconded by Luann Skarlupka, to adopt the agenda as

amended. Motion carried unanimously.

APPROVAL OF MINUTES OF SEPTEMBER 13, 2018

MOTION: Luann Skarlupka moved, seconded by Beth Smith-Houskamp, to approve the

minutes of September 13, 2018 as published. Motion carried unanimously.

INTRODUCTIONS, ANNOUNCEMENTS AND RECOGNITION

Cheryl Streeter, L.P.N. – Resignation

MOTION: Luann Skarlupka moved, seconded by Jennifer Eklof, to thank Cheryl Streeter

for her service to the Board of Nursing. Motion carried unanimously.

5

EDUCATION AND EXAMINATION MATTERS

Lakeland University – Request for Authorization to Plan (RN to BSN)

MOTION: Luann Skarlupka moved, seconded by Beth Smith-Houskamp, to

acknowledge and thank Kerry Hamm of Lakeland University for her

appearance before the Board. Motion carried unanimously.

MOTION: Luann Skarlupka moved, seconded by Beth Smith-Houskamp, to grant

Lakeland University authorization to plan a RN School of Nursing. Motion

carried unanimously.

APPEARANCE: GRETCHEN MROZINSKI – DELEGATION OF AUTHORITY TO THE

DIVISION OF LEGAL SERVICES AND COMPLIANCE (DLSC) FOR SPECIFIC CASES

MOTION: Pamela White moved, seconded by Jennifer Eklof, to delegate pre-screening

decision making authority to the DSPS Screening Attorney for opening cases

as outlined below:

1. OWIs of 3 or more that occurred in the last 5 years with an AODA

assessment that shows active impairment or addiction.

2. Reciprocal discipline cases.

3. Impairment and/or diversion at work that includes a positive drug test.

4. Conviction of misdemeanor or felony that the attorney believes is

substantially related and is not otherwise excluded by the new language of

Wis. Stat. ch. 111.

5. Allegations of diversion at work where complaint includes “admission” by

the nurse of diversion.

Motion carried unanimously.

MOTION: Pamela White moved, seconded by Jennifer Eklof, to delegate pre-screening

decision making authority to the DSPS Screening Attorney for closing cases

with 1 OWI conviction and no evidence of dependency. Motion carried

unanimously.

LEGISLATIVE/ADMINISTRATIVE RULE MATTERS

Act 262 Report

MOTION: Lillian Nolan moved, seconded by Luann Skarlupka, to approve the Act 262

Report on Opioid Abuse. Motion carried unanimously.

6

CLOSED SESSION

MOTION: Pamela White moved, seconded by Luann Skarlupka, to convene to closed

session to deliberate on cases following hearing (s. 19.85(1)(a), Stats.); to

consider licensure or certification of individuals (s. 19.85 (1)(b), Stats.); to

consider closing disciplinary investigation with administrative warning

(ss.19.85(1)(b), Stats. and 440.205, Stats.); to consider individual histories or

disciplinary data (s. 19.85 (1)(f), Stats.); and, to confer with legal counsel

(s.19.85(1)(g), Stats.). Peter Kallio, Vice Chair, read the language of the

motion. The vote of each member was ascertained by voice vote. Roll Call

Vote: Paul Abegglen-yes; Rosemary Dolatowski-yes; Jennifer Eklof-yes;

Peter Kallio-yes; Lillian Nolan-yes; Luann Skarlupka-yes; Elizabeth Smith-

Houskamp-yes; Pamela White-yes. Motion carried unanimously.

The Board convened into Closed Session at 9:13 a.m.

RECONVENE TO OPEN SESSION

MOTION: Pamela White moved, seconded by Jennifer Eklof, to reconvene into Open

Session. Motion carried unanimously.

The Board reconvened into Open Session at 11:41 a.m.

VOTING ON ITEMS CONSIDERED OR DELIBERATED ON IN CLOSED SESSION

MOTION: Paul Abegglen moved, seconded by Jennifer Eklof, to affirm all motions made

and votes taken in closed session. Motion carried unanimously.

(Be advised that any recusals or abstentions reflected in the closed session motions stand for the

purposes of the affirmation vote.)

CREDENTIALING MATTERS

Conviction Reviews

APPEARANCE: Kelli Engen, R.N. and Attorney Ashley Richter – Renewal Applicant

MOTION: Luann Skarlupka moved, seconded by Rosemary Dolatowski, to acknowledge

the appearance of Kelli Engen, R.N. and Attorney Ashley Richter before the

Board. Motion carried unanimously.

MOTION: Luann Skarlupka moved, seconded by Rosemary Dolatowski, to authorize the

Credentialing Liaison and Board Counsel to offer an amended 2-year limited

license to Registered Nurse Renewal applicant Kelli Engen, R.N. Motion


7

APPEARANCE: Jean Shanahan, R.N., and Attorney Patrick Knight – Renewal Applicant

MOTION: Lillian Nolan moved, seconded by Paul Abegglen, to acknowledge the

appearance of Jean Shanahan, R.N. and Attorney Patrick Knight before the

Board. Motion carried.

MOTION: Lillian Nolan moved, seconded by Paul Abegglen, to withdraw the limited

license offered to Jean Shanahan, R.N., and to approve her Registered Nurse

Renewal application. Motion carried.

(Pamela White recused herself and left the room for deliberation and voting in the matter

concerning Jean Shanahan, R.N.)

DIVISION OF LEGAL SERVICES AND COMPLIANCE MATTERS

Attorney Alicia Kennedy

Administrative Warnings

17 NUR 252 – G.L.F.

MOTION: Paul Abegglen moved, seconded by Jennifer Eklof, to issue an Administrative

Warning in the matter of 17 NUR 252 (G.L.F.). Motion carried unanimously.

17 NUR 646 – C.K.H.

MOTION: Paul Abegglen moved, seconded by Jennifer Eklof, to issue an Administrative

Warning in the matter of 17 NUR 646 (C.K.H.). Motion carried unanimously.

Stipulations and Final Decisions and Orders

16 NUR 638 – Andrea R. Elverman, L.P.N.

MOTION: Paul Abegglen moved, seconded by Jennifer Eklof, to adopt the Findings of

Fact, Conclusions of Law and Order in the matter of disciplinary proceedings

against Andrea R. Elverman, L.P.N., DLSC Case Number 16 NUR 638.


16 NUR 702 – Mandi L. Stelloh, L.P.N.



against Mandi L. Stelloh, L.P.N., DLSC Case Number 16 NUR 702. Motion


8

17 NUR 701 – Kiki Walker, R.N.



against Kiki Walker, R.N., DLSC Case Number 17 NUR 701. Motion carried

unanimously.

17 NUR 718 – Carol J. Sams, R.N.



against Carol J. Sams, R.N., DLSC Case Number 17 NUR 718. Motion


Monitoring

Department Monitor Jesse Benisch

Jamie Larsen, R.N.

Requesting Full Licensure

MOTION: Lillian Nolan moved, seconded by Pamela White, to grant the request of

Jamie Larsen, R.N., for full licensure. Motion carried unanimously.

Department Monitor Zoua Cha

Karleen Delikowski, R.N.

Requesting a Reduction in Drug Screens and Access to Controlled Substances

MOTION: Paul Abegglen moved, seconded by Lillian Nolan, to deny the request of

Karleen Delikowski, R.N., for a reduction in drug screens and access to

controlled substances. Reason for Denial: Failure to demonstrate continuous

and successful compliance. Respondent needs to fully comply with the

complete terms and conditions of the original Board Order (3/9/2017). Motion


Tracy Hoeppner, R.N. – Requesting Full Licensure

MOTION: Lillian Nolan moved, seconded by Jennifer Eklof, to grant the request of

Tracy Hoeppner, R.N., for full licensure. Motion carried unanimously.

Samantha Schlesner, R.N.– Requesting Full Licensure

MOTION: Lillian Nolan moved, seconded by Pamela White, to grant the request of

Samantha Schlesner, R.N., for full licensure. Motion carried unanimously.

9

Department Monitor Erin Graf

Coreen Elliott, R.N. – Violation of Board Order

MOTION: Paul Abegglen moved, seconded by Jennifer Eklof, to make a finding that

Coreen Elliott, R.N., has violated the terms of the Board Order (8/16/2012)

which is conduct imperiling the public health, safety and welfare. The Board

authorizes the Monitoring Liaison and Board Counsel to draft an Order

imposing a suspension and additional conditions and limitations as a result of

violation of the terms of the Order. Motion carried unanimously.

Case Closures

MOTION: Paul Abegglen moved, seconded by Pamela White, to close the DLSC Cases

for the reasons outlined below:

1. 16 NUR 386 – A.N.U. – Prosecutorial Discretion (P7)

2. 16 NUR 713 – J.T. – Insufficient Evidence

3. 16 NUR 744 – D.A. – Insufficient Evidence

4. 17 NUR 126 – S.C. – No Violation

5. 17 NUR 151 – D.J.M. – Prosecutorial Discretion (P2)

6. 17 NUR 487 – A.J.D. – No Violation

7. 17 NUR 583 – K.S. – No Violation

8. 17 NUR 615 – M.J. – Prosecutorial Discretion (P2)

9. 17 NUR 700 – K.A.T. – Insufficient Evidence

10. 18 NUR 194 – D.S.W. – No Violation


ADJOURNMENT

MOTION: Jennifer Eklof moved, seconded by Luann Skarlupka, to adjourn the meeting.


The meeting adjourned at 11:44 a.m.

10

AGENDA REQUEST FORM 1) Name and Title of Person Submitting the Request:

Joan R. Gage, OEE Program Manager

2) Date When Request Submitted:

10/31/2018

Items will be considered late if submitted after 12:00 p.m. on the deadline date which is 8 business days before the meeting

3) Name of Board, Committee, Council, Sections:

Board of Nursing

4) Meeting Date:

11/8/2018

5) Attachments:

Yes

No

6) How should the item be titled on the agenda page?

Lakeshore Technical College – Practical Nursing School Approval

7) Place Item in:

Open Session

Closed Session

8) Is an appearance before the Board being scheduled?

Yes

No

9) Name of Case Advisor(s), if required:

N/A

10) Describe the issue and action that should be addressed:

Lakeshore Technical College is seeking approval of their Practical Nursing School.

11) Authorization

Signature of person making this request Date

Supervisor (if required) Date

Executive Director signature (indicates approval to add post agenda deadline item to agenda) Date

Directions for including supporting documents: 1. This form should be attached to any documents submitted to the agenda. 2. Post Agenda Deadline items must be authorized by a Supervisor and the Policy Development Executive Director. 3. If necessary, provide original documents needing Board Chairperson signature to the Bureau Assistant prior to the start of a meeting.

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Wisconsin Department of Safety and Professional Services Mail To: P.O. Box 8366 1400 E. Washington Avenue

Madison, WI 53708-8366 Madison, WI 53708-8366 FAX#: (608) 266-2602 E-Mail: [email protected] Phone#: (608) 266-2112 Website: dsps.wisconsin.gov

BOARD OF NURSING

NURSING SCHOOL SELF-EVALUATION REPORT FOR INITIAL BOARD OF NURSING APPROVAL

As indicated in Chapter N 1.05, a school of nursing may apply for approval of the school of nursing upon graduation of the first class or eligibility to sit for the NCLEX, but may not apply later than graduation of the third class. The school of nursing shall submit a self-evaluation report setting forth evidence of compliance with the standards in N 1.08 and an evaluation of the NCLEX success rate. This form #3029 must be completed as part of the self-evaluation report for initial Board of Nursing approval.

Directions for completing the Self-Evaluation Report: On the line next to each requirement, please indicate the date of compliance or anticipated compliance, or "NA" for not applicable. For each "NA" indicated, please explain why the requirement does not apply to the nursing school in the space provided on page six or on attached clearly labeled pages.

After receiving the Self-Evaluation Report, the Board may conduct a site snrvey of the school of nursing to verify compliance with Board standards.

Please submit this completed and signed report to dspseJ<:aminationsoffice(til,wisconsin.gov.

Name of Nursing School: La k e shore :Jecho, ee;, \ ~He:3e~ Address: i .19Q 1\10( \\r\ f:\\lR,Y\M,~

Q\e\Je\0,0.d WI: 53015

Program (ADN, BSN, Other): ~.a,,c.;h c:d WvJs.(n_Q'.4------

An electronic version of Chapter N l is available at: h!!ps://docs.legis.wisconsin,gov/code/admin codelnLLpdf.

CHAPTER N 1.08(1) ORGANIZATION AND ADMINISTRATION

N 1.08 (l)(a) Governing Institution

NOTE: The Board may examine administrative policies during a site survey lo ensure Board standards are being met.

1. Yes Institution assumes legal responsibility for overall conduct of the school of nursing.

2. \.{e,5_ Institution has a designated educational administrator, established administrative policies and fiscal, human, physical, clinical and technical learning resources adequate to support school processes, security and outcomes.

3. 'j ~S Institution has maintained institutional accreditation; attach evidence of accreditation to Self-evaluation Report.

4. '::\es

#3029 (9114)

Institution has developed and maintained written school of nursing administrative policies which are in accord with the institution.

Page 1 of5

Wis. Admin. Code Ch. N I Corum[tted to Equal Opportunity in Employment and Lictmsi.ng 12

5. lies Wisconsin Department of Safety and Professional Services

Institution has written contracts in place between the school of nursing and institutions which offer associated academic study, clinical facilities and agencies for related services for students.

CHAPTER N 1.08(2)(a) EDUCATIONAL ADMINISTRATOR

6. L/es

1. Yes

8. vtes

9. L{e_:::,

10. 4e.~

Nursing school educational administrator holds a current, active registered nurse license or privilege to practice in Wisconsin that is not encumbered.

Nursing school educational administrator has evidence of a graduate degree with a major in nursing.

Nursing school educational adminish·ator has knowledge of learning p1inciples for adult education, including nursing curriculum development, administration and evaluation, and either educational preparation or 2 years experience as an instructor in a nursing education program within the last 5 years.

Educational administrator has current knowledge of nursing practice.

Institution must notify the board within 48 hours of the termination, resignation or retirement of an educational administrator and designate the interim educational administrator within 5 business days. The institution may request board approval of an interim educational administrator who does not meet the qualifications in N 1.08 (2)(a), but the interim educational administrator may serve no longer than 6 months. The institution may request an extension of time based upon hardship.

CHAPTERN 1.08/3) FACULTY

NOTE: Evidence of meeting faculty standards shall be noted on Form #1114 and kept on file in the School of Nursing office and the forms may be examined by the Board representative(s) during the survey.

11. Ye.;:,

12. ltes

13. Yes

14. Li-e.s

15. ¼es 16. tJr\

School of nursing has evidence of the faculty meeting the standards in N 1.08 on file in the school of nursing office and available to the board upon request.

All faculty of the school of professional nursing hold a current, active registered nurse license or privilege to practice in Wisconsin that is not encumbered.

All faculty of the school of professional nursing have a graduate degree with a major in nursing. Interprofessional faculty teaching non-clinical nursing courses all have advanced preparation appropriate for the content being taught.

All faculty of the school of practical nursing hold a current, active registered nurse license or privilege to practice in Wisconsin that is not encumbered.

All faculty of the school of practical nursing have a baccalaureate degree with a major in nursing.

· If faculty exceptions are utilized, all were requested for approval following requirements in N 1.08 (3)(d).

CHAPTER N 1.08(4)(a) CURRICULUM

11. Yes

18. \.ies

Curriculum enables the student to develop the nursing knowledge, skills and abilities necessary for the level, scope and standards of competent nursing practice expected at the level of licensure.

Curriculum is developed by a faculty member with a graduate degree and is revised as necessary to maintain a program that reflects advances in health care and its delivery.

Page 2 of 5 13

Wisconsin Department of Safety and Professional Services

19. The curriculum includes all of the following:

(a) 4e'::i

Cb) Yes

Evidence-based learning experiences and methods of instruction consistent with the written curriculum plan. Note: Method of instruction may include distance education methods.

Diverse, didactic and clinical learning experiences consistent with program outcomes.

20. Coursework includes all of the following:

ca) Ye'.:> Content in the biological, physical, social and behavioral sciences to provide a foundation for safe and effective nursing practice.

(b) lf es Content regarding professional responsibilities, legal and ethical issues, and history and trends in nursing and health care.

(c) Yes Didactic content and supervised clinical experiences in the prevention of illness and the promotion, restoration and maintenance of health in patients across the lifespan and from diverse

cultural, ethnic, social and economic backgrounds.

CHAPTER N. 1.08(5) CLINICAL LEARNING EXPERIENCES

NOTE: The Board may inspect clinical facilities during a site survey to ensure Board standards are being met.

21. Patient experiences occur in a variety of clinical or simulated settings and include all of the following:

(a) L(e,.s

(b) Lfes

(c) L(es

1) 4es 2) \.{es 3) \..\es . 4) '-:\es

(d) ~e.s

Integration of patient safety principles throughout the didactic and clinical coursework.

Implementation of evidence-based practice to integrate best research with clinical expe1tise and patient values for optimal care, including skills to identify and apply ef-best practices to nursing care.

Provision of patient-centered culturally competent care that recognizes that the patient or designee is the source of control and full partner in providing coordinated care by doing the following:

Respect of patient differences, values, preferences, and expressed needs.

Involvement of patients or designees in decision-making and care management.

Coordination and management of patient care across settings.

Explanation of appropriate and accessible interventions to patients and populations that may positively affect their ability to achieve healthy lifestyles.

Collaboration of interprofessional teams to foster open communication, mutual respect and shared decision-making in order to achieve quality patient care.

( e) L( €,S Participation in quality improvement processes to monitor patient care outcomes, identify possibility of hazards and errors and collaborate in the development and testing of changes that improve the quality and safety of health care systems.

(f) L{ es Use of information technology to communicate, mitigate errors and support decision-making.

Page 3 of5 14

22. L(e.s

23. \..{ es.

24. Yes

(a) ½es (6) I..( es (c) l1es. (d) Y.e-, 25. ~es 26. Ye~


All cooperating agencies selected for clinical experiences have standards which demonstrate concern for the patient and evidence of the skillful application of all measures of safe nursing practices.

All faculty teaching clinical or practicum courses are experienced in the clinical areas of the course and maintain clinical expertise.

Faculty-supervised clinical practice includes all of the following:

Development of skills in direct patient care.

Making clinical judgments.

Care and management of both individuals and groups of patients across the lifespan.

Delegation to and supervision of other health care providers.

Clinical experiences shall be supervised by qualified faculty.

All student clinical experiences, including those with preceptors, shall be directed by nursing faculty.

CHAPTER N 1.08(6) PRECEPTORS

27. /.J A Preceptors shall be approved by the faculty of the school of nursing:

28. Afflr School of nursing shall provide each preceptor with an orientation concerning the roles and responsibilities of the students, faculty and preceptors. The preceptor shall have clearly documented roles and responsibilities.

29. NA Clinical preceptors shall have an unencumbered license or privilege to practice in Wisconsin as a nurse at or above the licensure level for which the student is being prepared.

30. NA Preceptors shall demonstrate competencies related to the area of assigned clinical teaching responsibilities.

CHAPTER N 1.08(7) EVALUATION

31. L/es Educational administrator shall implement a comprehensive, systematic plan for ongoing evaluation and evidence of implementation shall reflect progress toward or achievement of program outcomes.

CHAPTER N 1.09 NCLEX PASS RA TES

IMPORTANT: School of nursing NCLEX pass rate includes all programs or tracks in the school of nursing. The Board shall consider both the registered nurse NCLEX and practical nurse NCLEX pass rates when evaluating a school of professional nursing that grants a certificate of completion for practical nursing.

32. l(e:::, Nursing school must provide a self-evaluation ofNCLEX success rate, including any current steps being taken to improve NCLEX success rate or plans to implement steps in the near future.

Page 4 of5 15


SELF-EVALUATION NOTES

For each "NA" indicated in this report, please provide an explanation as to why the rule does not apply to the specific nursing school in the space provided below. Please write the corresponding report item number for each explanation. Attach clearly labeled additional pages as necessary.

* llo - )\JO -P0-.e.-t,1 .. \4 ex.cepnDr'\:S. Ae.eJc:d.

-J¼ .?-.1- 30 ~ ~o ?<ece~\-ors u.:-,e...d,

REPORT/FORM COMPLETED BY:

~ Oou) m5rJ 15 1tJ. Educati~l Administrator

S~eQ,n,.___,)

Telephone Number

Page 5 of5 16

•~ ~, HIGHER LEARNING COMMISSION

Lakeshore Technical College Institutional Status and Requirements Report Institution and Contact Information

Institution ID:

Institution Name:

Institution Address:

Phone:

Web Page:

Accreditation Liaison Officer (ALO) :

Chief Academic Officer (CAO) :

Chief Executive Officer (CEO) :

Chief Financial Officer (CFO) :

Data Update Coordinator :

Accreditation Status

Accreditation Status:

Accredited

Candidate

Nature of Institution

Control:

Degrees Awarded:

Reaffirmation of Accreditation

1859

Lakeshore Technical College

1290 North Avenue, Cleveland, WI 53015

(920) 693-1000

www.gotoltc.edu

Karla Zahn ([email protected])

Barbara Dodge ([email protected])

Michael Lanser ([email protected])

Molly O'Connell (molly.o'[email protected])

Cheryl A Terp ([email protected])

Accredited

04/13/1977 -

07/20/1973 - 04/12/1977

Public

Associates

Year of Last Reaffirmation of Accreditation: 2014 - 2015

Year of Next Reaffirmation of Accreditation: 2024 - 2025

Accreditation Liaison

Accreditation Stipulations

General:

Jeffrey Rosen

Prior Commission approval is required for substantive change as stated in Commission policy.

Additional Location:

Toe Commission's Notification Program is available for new locations within the Commission's 19-state region.

Distance and Correspondence Courses and Programs:

Approved for distance education courses and programs. The Institution has not been approved for correspondence education,

Lakeshore Technical College Institutional Status and Requirements Report

Report generated on Jui 20, 2016 Page 1

17

Accreditation Events

Accreditation Pathway:

Upcoming Events:

Comprehensive Evaluation:

Assurance Review:

In-process Events:

Monitoring

Upcoming Events:

In-process Events:

Institutional Data

Educational Programs Offered

Undergraduate

Certificates

Associate Degrees

Baccalaureate Degrees

Graduate

Master's Degrees

Specialist Degrees

Doctoral Degrees

Extended Operations

Branch Campuses

Additional Locations

Open Pathway, Year 1

2024 -2025

08/01/2018

111

37

0

0

0

0

Cedar Grove-Belgium High School, 321 N. 2nd Street, Cedar Grove, WI, 53013 - Inactive

Johnsonville Sausage, N6928 Johnsonville Way, Sheboygan Falls, WI, 53085 - Active

Kiel High School, 210 Raider Heights, Kiel, WI, 53042 - Inactive

Lakeshore Culinary Institute , 712 Riverfront Drive, Sheboygan, WI, 53081 -Active

L TC Manitowoc, 3733 Dewey St., Manitowoc, WI, 54220 - Active

L TC Sheboygan, 3620 Wilgus Ave., Sheboygan, WI, 53081 - Active

LTC-Plymouth Science and Technology Center, 125 Highland Avenue, Plymouth, WI, 53073 - Inactive

Mishicot High School, 660 Washington St, Mishicot, WI, 54228 - Inactive

Reedsville High School, 340 Manitowoc Road, Reedsville, WI, 54230 - Inactive

Two Rivers High School, 4519 Lincoln Ave, Two Rivers, WI, 54241 - Inactive

Distance Delivery


Report generated on Jul 20, 2016 Page2

18

In an effort to present a more complete picture of the offerings at member institutions, HLC is exploring the feasibility of collecting information regarding the institutional program offerings and publishing them in the ISR Report. At this time, HLC is documenting member institutions' distance delivery offerings through HLC's distance education stipulation. HLC stipulations identify the approval level regarding an institution's offerings. HLC is not displaying up-to-date information regarding each distance education offering at an institution. More information about this project will be available in the coming year.

09.0799 - Radio, Television, and Digital Communication, Other, Associate, 10-170-1 Broadcast Captioning

13.1210-Early Childhood Education and Teaching, Associate, 10-307-1 Early Childhood Education

22.0303 - Court Reporting/Court Reporter, Associate, 10-106-1 Court Reporting

41.0205 - Nuclear/Nuclear Power TechnologyfTechnician, Associate, 10-624-1 Nuclear Technology

51.0805 - Pharmacy Technician/Assistant, Certificate, 31-536-1 Pharmacy Technician

51.0907 - Medical Radiologic Technology/Science - Radiation Therapist, Associate, 10-526-1 Radiography

51.2011 - Pharmaceutical Marketing and Management, Associate, 10-536-1 Pharmacy Services Management

51.3801 - Registered Nursing/Registered Nurse, Associate, 10-543-1 Nursing-Associate Degree

51.3901 - Licensed PracticalNocational Nurse Training, Certificate, 31-543-1 Practical Nursing

52.0201 - Business Administration and Management, General, Associate, 10-102-3 Business Management

52.0203- Logistics, Materials, and Supply Chain Management, Associate, 10-182-1 Supply Chain Management 52.0205 - Operations Management and Supervision, Associate, 10-196-1 Supervisory Management

52.0408 - General Office Occupations and Clerical Services, Certificate, 31-106-1 Office Assistant

52.0904 - Hotel/Motel Administration/Management, Associate, 10-109-1 Hotel/Hospitality Management

52.1001 - Human Resources ManagemenUPersonnel Administration, General, Associate, 10-196-4 Human Resources 52.1401 - Marketing/Marketing Management, General, Associate, 10-104-3 Marketing

Correspondence Education

Contractual Arrangements

Consortia! Arrangements

Non-Financial Indicators

Financial Indicators

History

5/4/2015 - Quality Checkup, Continue Accreditation.

6/30/2014 - Institutional Change: Notification, Request Approved. Request for access to the Notification Program for additional locations.

11/9/2013 - Strategy Forum.

7/18/2012 - Change Panel, Additional Location Added. Approved three additional locations: LTC Manitowoc, Manitowoc, WI; Lakeshore Culinary Institute, Sheboygan, WI; L TC Sheboygan, Sheboygan, WI


Report generated on Jul 20, 2016 Page 3

19

7/16/2012 - Institutional Change: Location,. CHANGE PANEL: Request to open three additional locations: L TC Manitowoc 3733 Dewey St., Manitowoc, WI 54220

Lakeshore Culinary Institute 712 Riverfront Drive Sheboygan, WI 53081

L TC Sheboygan 3620 Wilgus Ave. Sheboygan, WI 53081

5/16/2011 -Desk Review, Certificate approved. Horticulture Technician GIP: 1.0699

3/12/2009 - AQIP, Systems Appraisal Feedback Report.

5/8/2008 - AQIP, Reaffirmation of Accreditation.

3/21/2007 - AQIP, Quality Checkup Report.

1/8/2002 - AQIP, Action Project Annual Update.

9/16/2000 -AQIP, Participation in AQIP. Agreement signed for Participation in AQIP

9/16/2000 -AQIP, Schedule Reaffirm. of Accred .. Current accreditation status extended to 2007-08.

2/25/2000 - Staff Recommendation, Visit postponed. Next comprehensive postponed to 2002-03.

5/5/1993 - Staff Action, Cancel report required. Report no longer required for 1/1/94.

5/5/1993 - Staff Action, Progress report accepted. Report outlining: 1) which outcomes it proposes to assessin its initial assessment of student academic achievement, 2) precisely which data it intends to collect to document those outcomes, and 3) how and when it intends to collect those data. Each component of the required report should be responsive to student academic achievement assessment guidelines published by the North Central Association.

8/7/1992 - Continued Accreditation, Accreditation continued.

8/7/1992 - Continued Accreditation, Progress report required. 1/1/93: report outlining: 1) which outcomes it proposes to assassin its initial assessment of student academic achievement, 2) precisely which data it intends to collect to document those outcomes, and 3) how and when it intends to collect those data. Each component of the required report should be responsive to student academic achievement assessment guidelines published by the North Central Association.

8/7/1992 - Continued Accreditation, Progress report required. 1/1/94: report which present specific ouotcomes data in accordance with the plans outlined in the report filed the previos January and with student academic achievement guidelines of NGA. The report should demonstrate that the assessment plans of the institution have been successfully implemented.

6/3/1992 - Staff Action, Editorial Change. Diploma added to Educational Programs section.

10/26/1982 - Continued Accreditation, Accreditation continued.

4/1/1980 - Staff Action, Progress report accepted.

4/13/1977 - Initial Accreditation, Accreditation granted.

4/13/1977 - Initial Accreditation, Progress report required. 4/1/80: report dealing with items identified by the visiting team. 4/8/1975 - Continued Candidacy, Candidacy continued.

8/1/1973 - Change Visit, Consultant Assigned.

7/20/1973 - , Candidacy status revised. Institution became Candidate for Accreditation under new policy.

3/28/1973 - Initial Candidacy, Candidacy granted. Recognized Candidate for Accreditation status granted at Associate's level.

9/1/1970 - Change Visit, Consultant Assigned.

4/8/1970 - , Correspondent status granted.


Report generated on Jul 20, 2016 Page 4

20

Accreditation Commission for Education in Nursing

Has Awarded

Accreditation to

Lal<eshore Technical College Practical Nursing Program

For Achievement of Quality and Excellence in Nursing Education

Spring 2018 - Spring 2023

tACEN I Accreditation Commission

for Education in Nursing

~~ne~,~ Chair,ACEN

~~~ Marsal P. Stoll, EdD, MSN Chief Executive Officer,ACEN

21

I, --- ,_, L) NCLEX Pass Rates - Board Approved RN Schools

.. ~me!'l'11~~~t~JI ••"...:':c,,;;,irf:ft'j'~jti 1 Percentage of 1st time RN candiates who passed the NCLEX.

12 Percentage of all RN candidates who passed the NCLEX regardless of times taking the lest.

_,1 This is percentage is only calculated for schools who did not meet the standard of 1st time takers. 3 PN Candiates receiving a certficate of completion from a RN school to take the PN NCLEX. 4 Percentage of 1st time PN candiates who passed the NCLEX. 5 Percentage of a!! RN candidates who passed the NCLEX regardless of times taking the test. This is percentage is only

3

I ~ .. _,: w: : : : : : ~r:·,:::,:·~:~:~,:h~~; ~ tJ -ti: fXl.5Sed LI g

~ Q.o.Y"\ ~ - 4q =

Herzing College ~ Madison #I ---

US50405500 #Cand 84

US50102000 I I I

Lakeshore Tech College I# Passed I 51

US50407600 I# Cand I 55J

US50109800 I I I

Madison Area Tech College # Passed 149

US50407900 #Cand 174

US50105600 I I I

Maranatha Baptist Bible Col. #Passed 11

US50500100 #Cand 111

Marian University # Passed 691

US50503900 #Cand 89I

Marquette University # Passed 1461

US50509000 #Cand 1591

Mid State Tech College # Passed 5sl

US50400000 l#Cand I sol

59.52 76.0

# Passed

I 1#Cand

92.73 # Passed

I i# Cand

85.63 # Passed ---

I i#Cand

100.00

77.53 I 95.0

91.82

93.33

11

11 100.00

32

33 96.97

62

62 100.00

a. 7. cu~ 'lo

Stv-r"/0 o.\oY'le. ~ -.vq i'l<-ff\ ( new') i)tJ -:1'.l'.- posse d 1-

-½!,;. 1 _ n.. ;::: 100· ~Q., '

( l e_c,""~~~ ho.s n~ ~\'.-e.~ -YlO ~S'-'-~ "\-e..\-)

22

! i

'

Component

EOPSLO#l Implement one's role

as a nurse in ways that

reflect integrity,

responsibility, ethical

practices, and an

evolving identity as a nurse committed to

caring, advocacy, and

quality care while

LAKESHORE TECHNICAL COLLEGE PRACTICAL NURSING PROGRAM

SYSTEMATIC EVALUATION PLAN

End-of-program Student Learning Outcomes and Program Outcomes (EOPSLO)

PLAN IMPLEMENTATION

Result of Data I Collection and Actions

Analysis For Program Expected Including actual Development,

I Assessment Level of Frequency of I level{s) of Maintenance, or Method(s) Achievement Assessment I Achievement Revision

; Students will take 80% of the Biannually in l 100% of the students ELA met. Continue to · the HESI , students score at May of odd scored at or above monitor.

Fundamentals exam an acceptable level • years (2019) the acceptable level at the end of (850) or above on (850). i Introduction to the HESI Clinical Fundamentals

' exam in area of · NLN Educational

Competency "Professional

· Identity

:

. adhering to evidence

based practice.

I

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23

Students will assess the core ability of "Responsible and Professional Workplace Behavior" by the end of the semester in Nursing Fundamentals.

A minimum of 10

questions will be

linked to

EOPSLO#l on the

final exam for

Nursing Health

Alterations


80% of students Biannually in will meet the core August of ability of odd years "Responsible and (2019) Professional Workplace Behavior" by the end of the semester in Nursing Fundamentals.

80% of students Bia_nnually in will score 80% or May of odd higher on test years (2019) items linked to EOPSLO #1

100% of students ELA met. Will continue

met this core ability to monitor.

in Nursing

Fundamentals.

25% ofthe students PN cohort consisted of 8

scored 80% or higher students. Difficult to

on test items linked determine validity of

to EOPSLO #1. results based on such a small number. Faculty reworded the exams to most closely mirror NCLEX style format and will deploy this exam in Spring 2019. Nursing program has also implemented a test revision policy to determine the validity and reliability of test items. This was instituted in FA 18.

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EOPSL0#2 Students will take

Demonstrate the HESI PN Exit

appropriate written, Exam at the end of

verbal, and nonverbal Health Promotions.

communication in a variety of clinical contexts.

Students will assess their core

ability of "Communicates Effectively" in Health Promotions.


80% of the Biannually in

students score at May of even

an acceptable years (2020)

level (850) or above on the HESI PN Exit exam in area of Nursing Concepts ucommunicationll

80% of students Biannually in

will meet the core May of even

ability of years (2020)

"Communicates Effectively" in

Health Promotions by the end of spring semester

75% of the students ELA not met. Due to

scored at or above small number of

the acceptable level students in the cohort

of the HESI (8) it is difficult to

Fundamentals Exam determine validity of

in the area of results. Will continue

Nursing Concepts to monitor. 11Communicationsl/

100% of students met ELA met. Will continue

the core ability of to monitor.

"communicates effectively."

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25

Students will complete the Process Recording assignment in Clinical Care Across the Lifespan

EOPSL0#3 Students will take Integrate knowledge of the HESI PN Exit social, mathematical, exam at the end of and physical sciences, Health Promotions pharmacology, and disease processes while participating in clinical decision making.


80% of students Biannually in will achieve an May of even 80% or higher on years {2020) the Process Recording assignment in Clinical Care Across the Lifespan

80% ofthe Annually in students score at May of odd an acceptable years {2019) level {850) or above on the HESI PN Exit exam in area of NLN Educational Competencies "Nursing Judgment"

100% of students ELA met. Will continue received a score of at to monitor. least 80% in the Process Recording assignment.

67% of the students ELA not met. Due to scored at acceptable small number of level or above on the students in the cohort HESI Fundamentals {8) it is difficult to Exam in the area of determine validity of N LN Educational results. Will continue Competencies to monitor another "Nursing Judgment" year.

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Students will take a dosage calculation exam in Intro to Clinical Care Management.

A minimum of 10 test items for the Pharmacology final exam will b.e linked to EOPSLO #3



students will May of odd

score 80% or years {2019)

higher on the dosage calculation exam in Intro to Clinical Care Management

80% of students Biannually in

will score 80% or January of

higher on the odd years items linked to (2019)

EOPSLO #3 in the Pharmacology

final exam

87 .5% of students ELA met. Will continue

scored 80% or higher to monitor. Faculty

on the dosage has revised the

calculation exam in calculation exam to

Intro to Clinical Care reflect the NCSBN

Management guidelines for math NCLEX test items.

Test items for Plan to use test items

Pharmacology will be linked to this EOPSLO

linked to test items using EAC Visual

starting in fall 2018 Nursing Pharmacology in fall semester as third method of

assessment.


27

EOPSL0#4 Students score will Provide patient take the HESI centered care under Fundamentals supervision by exam at the end of participating in the Intro to Clinical nursing process across diverse populations and health care settings

Students will take the HESI PN Exit exam at the end of Intro to Clinical


80% of the Biannually in students score at January of an acceptable even years level (850) or (2020) above on the HESI Fundamentals exam in area Nursing Process "Assessment"

80% of the Biannually in students score at May of even an acceptable years (2020). level (850) or above on the HESI PN Exit exam in area Nursing Process "Implementation"

60% ofthe students ELA not met. Faculty score at an have made revisions acceptable level to Skills course which (850) or above on covers assessment to the HESI include more case Fundamentals exam studies. Have in area Nursing extended time in Skills Process lab to increase ((Assessment" amount of practice

time available to students. Have added academic support staff to assist students in learning assessment skills.

87.5% ofthe ELA met. Will continue students scored an to monitor. acceptable level (850) or above on the HESI PN Exit exam in the area of Nursing Process "Implementation"

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Students will assess the core ability of "Respect and Appreciate Diversity" in

Clinical Care Across the Lifespan

EOPSLO#S Students will take Minimize risk of harm the HESI

to patients, providers, Fundamentals and self through safe exam at the end of individual Intro to Clinical performance and

participation in system effectiveness.


80% of the Biannually in student will meet May of even the core ability of years (2020) "Respect and

Appreciate Diversity" in Clinical Care Across the Lifespan

80% of the Biannually in students score at January of an acceptable odd years level (850) or (2019) above on the HESI Fundamentals

exam in area of Client Needs "Safety and Infection Control"

100% of the students ELA met. Continue to have met the core monitor. ability.

92% of the students ELA met. Will continue score at an to monitor acceptable level (850) or above on the HESI Fundamentals exam in area of Client Needs "Safety and Infection Control"


29

Students will take the HESI PN Exit exam at the end of Health Promotions

A minimum of 10 test questions will be linked to EOPSLO #5 in the final exam for Nursing Health Alterations


80% of students Biannually in score at an January of acceptable level odd years (850) or above on (2019) HESI PN Exit exam in the area of Client Needs "Safety and Infection Control"

80% of students Biannually in will score an 80% May of odd or higher on test years (2019) items linked to EOPSLO #5 in the final exam for Nursing Health Alterations

62% ofthe students ELA not met. Due to scored at an small cohort size (8) acceptable level Will continue to (850) or above on monitor for another the HESI year. Fundamentals exam in the area of Client Needs "Safety and Infection Control"

25% of students PN cohort consisted of 8

scored 80% or higher students. Difficult to

on test items linked determine validity of

to EOPSLO #5 in the results based on such a

final exam for small number. Faculty

Nursing Health reworded the exams to most closely mirror

Alterations NCLEX style format and will deploy this exam in Spring 2019. Nursing program has also implemented a test revision policy to determine the validity and reliability of test items. This was instituted in FA 18.

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EOPSLO#6 Students will take

Collaborate as an active the HESI

member of the Fundamentals

multidisciplinary health exam at the end of

care team to provide Intro to Clinical

effective patient care throughout the lifespan.



students score at May of even

an acceptable years level (850) or above on the HESI Fundamentals exam in area of Nursing Concepts "Collaboration-Managing Care"

33% of the students ELA not met. Students

score at an receive most of the

acceptable level information on

(850) or above on management of care

HESI Fundamentals in second semester

exam at the end of theory course and

Intro to Clinical. practice this in their clinical courses by managing 2 to 6 residents. Dietician and respiratory therapist meet with the students in the clinical setting to discuss their roles. Need to develop multidisciplinary team members into simulation since students do not encounter them in their evening clinical courses. HESI PN exam

results for "Collaboration-managing care" increased to 75% of students scored at acceptable level or above. Will continue to monitor.


31

EOPSLO#6 Students will Collaborate as an active assess the core member ofthe ability of "Work multidisciplinary health Cooperatively" in care team to provide Clinical Care Across effective patient care the Lifespan throughout the lifespan (cont.)

A minimum of 10 test questions on the final exam for Nursing Health Alterations will be linked to EOPSLO #6

EOPSLO#7 Students will take Use information and the HESI technology to Fundamentals communicate, manage exam at the end of data, mitigate error, Intro to Clinical and assist with decision making


80% of students Annually in will meet the core spring ability of "Work semester Cooperatively" in Clinical Care Across the Lifespan

80% of students Biannually in will score 80% or May of even higher on test years (2020) questions linked to EOPSLO #6 on final exam in Health Alterations

80% of students Biannually in will score at or May of odd above the years (2019) acceptable level (850) in the HESI Fundamentals subcategory of Nursing Concepts "Informatics-Technology"

100% of students ELA met. Will continue were able to meet to monitor. this core ability.

75% of students ELA not met. Due to scored 80% or higher small number of on test items linked students in cohort, will to EOPSLO #6 on continue to monitor. final exam in Health Alterations.

58% of students ELA not met. Plans are scored at or above to include more the acceptable level information on this in the HESI topic in Health subcategory of Alterations and add Nursing Concepts questions to the "Informatics- course exams to Technology" in HESI assess the student's Fundamentals Exam knowledge prior to the

HESI PN Exit Exam in SPR 19.

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Students will assess the core ability of "Integrate Technology" in Nursing Pharmacology.

A minimum of 10 questions will be linked to EOPSLO #7 in final exam of Nursing Health Alterations.

80% of students will successfully demonstrate the clinical course competencies (which are identical to the EOPSLO's) for each clinical course.


80% of the Biannually in students will January of meet the core odd years ability of (2019) "Integrate Technology" in Nursing Pharmacology.

80% of students Biannually in will score at least May of odd 80% on test items years (2019) linked to #EOPSLO #7 on final exam in Nursing Health Alterations

80% Annually in May

90% of students ELA met. Will continue were able to meet to monitor. the core ability.

Plan to start in Spring Plan to use test items 2019. linked to this EOPSLO

using EAC Visual (which will be available Fall 2018) in Nursing Health Alterations as third assessment method.

100% of students At this point ELA is were able to met. One student was

demonstrate the unsuccessful in clinical clinical course due to separate competencies. course assignment

scores (i.e. care plans, communication assignment, etc.) but was able to demonstrate the EOPSLOs during


33

Licensure Exam Pass Based on State

Rate Board of Nursing NCLEX** Information.

Program Completion Compare number

Rates of students who complete the program to the number of students in the Practical Nursing program at the beginning ofthe Nursing Skills course. Students will graduate within two (2) semesters.


80% of PN Annually in graduates pass October NCLEX PN on the first attempt. 70% of students Annually in completed the PN May program within 3 semesters.

ELA Rationale: Same asADN

patient care. Continue to monitor.

100% of PN ELA met. Continue to graduates passed monitor. NCLEX PN on first attempt.

S3% completion rate Will not be able to at end of first meet the ELA. One semester due student not able to

student pass Nursing Skills failures/incompletion class due to rigor of

due to family and course and health concerns. family/work demands.

Student was encouraged to repeat course but student is now enrolled in MA class which she states is better "fit" for her at this time. One student was not able to complete due to complications from her pregnancy. Returned to program in fall 2018. Another student dropped out of program stating she had family concerns. Student did not respond to instructor

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or program counselor when she was contacted and encouraged to take the course again.

Pharmacology is the course with highest attrition. Course instructor and Associate Dean met weekly to monitor students' progress throughout semester to develop means to provide academic support to the students. Newly hired PN instructor joined meetings starting the end of October.

Course Statistics: 1. Section offered

a. 13 enrolled b. 2 withdrew c. 7 passed d. 4 did not

meet the 80% exam average

to pass


35


e. 63.6% pass rate ofthose completing

f. 53.8% pass rate of those enrolled

2. Test Blueprint Identify the development or any modification of test blueprint for each learning plan/final exam. Discuss changes to test blueprint and rationale for the change: • Initially, all course exams, quizzes, practice exams, unit exams, and the final were modeled after the ADN pharmacology course. After the first exam, it was noted that the quizzes, practice exams, and unit exams included duplicate _guestions.

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New questions created to cover the content and duplicate questions were eliminated. In addition, minimally one math question was included in each of the subsequent exams.

Test analysis 1. Test analysis was conducted on each exam utilizing Blackboard's EAC Visual data. Based on the item analysis, test questions were nullified if p-value was statistically less than 40%. If the exam item had a p-value of 50% but the point biserial was negative the exam question was nullified. Partial credit was granted for any questions with multiple components

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37


assigned multiple points. To achieve alignment with course objectives the new PN instructor audited the course to: review the course material being presented in the class lecture; review each exam for congruency of materials being presented and tested; review alignment of each exam question to course objectives

Plan was developed to improve exam pass rates< 80% during the fall of 2017:

Study Group: All students were encouraged to participate in weekly_ study groups to enhance their understanding ofthe course materials. Only one of the students who was not

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38


successful in the course attended. Faculty offered to work with individual's schedules to provide tutoring on a weekly basis. Students who failed did not take advantage ofthis opportunity.

Exam Review: Students were encouraged to meet with the instructor to review the module exam prior to taking the next module exam. The students

could review the exam either before or after class or set up an appointment with the instructor. Only one student who failed took advantage of this option.

Exam Aid: An exam aid in the form of one 3X5 note card was


39


allowed for all the computerized proctored exams as well as the face to face proctored final exam.

Fall 2017 semester issues: New Instructor New course instructor was assigned 2 weeks prior to start of the course due to unexpected events. Newly hired PN instructor joined the course as academic support staff in middle of October.

New schedule/time of delivery Schedule and time of delivery of course unchanged but required reading and pre-course work was expected prior to the face to face class. Additionally, all exams were expected to be

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LAKESHORE TECHNICAL COLLEGE PRACTICAL NURSING PROGRAM·

taken outside of allotted class time to devote the full class time to course delivery.

New grading plan No changes in grading plan, however students who did not score the required 80% on their cumulative exam grades were given the opportunity to take a second final exam. Four students chose this option. All four students scored less than the original final score. These students will be able to repeat the course in the fall semester 2018.

New Assignments: Tools to complete medications sheets were provided and encouraged but use was O)J_tional.

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•Fall 2018 course changes planned: 1. New instructor PN instructor who functioned as Academic Specialist will be the course instructor for in Fall 2018. Academic Specialist will be available for study groups and tutoring

2. New schedule/time of delivery Schedule and time of delivery of course is unchanged but exams will be completed during class time. No outside testing is required. 3. New grading plan: Grading plan will remain the same but Mandatory Academic Coaching will be required for students who do not p_ass an

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42

Job Placement Rate Compile the results of the Graduate Satisfaction Survey.


ELA: 80% Annually in November

ELA Rationale: Same asADN

No graduates until May 2018

exam or who are repeating the course. Academic specialist may meet with students on line using Blackboard Collaborate if students are not able to meet on campus due to scheduling difficulties.

4. Changes in assignments or assessments: Students will be required to complete medication sheets per learning plan and schedule

Data will be available in November 2018

*Most recent annual licensure examination pass rate will be at least 80% for all first-time test takers during the same 12-month period.

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43

AGENDA REQUEST FORM 1) Name and Title of Person Submitting the Request:

Sharon Henes Administrative Rules Coordinator

2) Date When Request Submitted:

26 October 2018

Items will be considered late if submitted after 12:00 p.m. on the deadline date which is 8 business days before the meeting

3) Name of Board, Committee, Council, Sections:

Board of Nursing

4) Meeting Date:

8 November 2018

5) Attachments:

Yes

No

6) How should the item be titled on the agenda page?

Legislative and Administrative Rule Matters 1. Act 108 Report – Review of chapters N 2 and 4 2. Updates on Legislation and Pending or Possible Rulemaking Projects

7) Place Item in:

Open Session

Closed Session

8) Is an appearance before the Board being scheduled?

Yes

No

9) Name of Case Advisor(s), if required:

10) Describe the issue and action that should be addressed:

11) Authorization

Sharon Henes 10/26/18 Signature of person making this request Date

Supervisor (if required) Date

Executive Director signature (indicates approval to add post agenda deadline item to agenda) Date

Directions for including supporting documents: 1. This form should be attached to any documents submitted to the agenda. 2. Post Agenda Deadline items must be authorized by a Supervisor and the Policy Development Executive Director. 3. If necessary, provide original documents needing Board Chairperson signature to the Bureau Assistant prior to the start of a meeting.

44

5 N 2.11BOARD OF NURSING

Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page

is the date the chapter was last published. Register August 2016 No. 728

Chapter N 2

LICENSURE

Subchapter I — Authority; DefinitionsN 2.01 Authority.N 2.02 Definitions.

Subchapter II — Licensure By ExaminationN 2.10 Qualifications for licensure.N 2.11 Application procedure for applicants from board−approved schools.N 2.12 Application procedure for applicants from comparable schools.

Subchapter III — Licensure by EndorsementN 2.20 Endorsement of an applicant from a nurse licensure compact state.N 2.21 Endorsement of an applicant from another U.S. state, territory or Canada.

Subchapter IV — Temporary PermitsN 2.30 Definitions.N 2.31 Application.N 2.32 Title.N 2.33 Supervision.N 2.34 Duration.N 2.35 Renewal.N 2.36 Denial or revocation.

Subchapter V — RenewalN 2.40 Renewal.N 2.41 Reinstatement.

Note: Chapter N 4 as it existed on July 31, 1981 was repealed and a new chapterN 4 was created effective August 1, 1981. Chapter N 4 as it existed on March 31, 1984was repealed and a new chapter N 2 was created effective April 1, 1984. Chapter N2 as it existed on July 31, 2014 was repealed and a new chapter N 2 was created effec-tive August 1, 2014.

Subchapter I — Authority; Definitions

N 2.01 Authority. (1) This chapter is adopted pursuant toauthority of ss. 15.08, 227.11, and 441.01 (3), Stats.

History: Cr. Register, March, 1984, No. 339, eff. 4−1−84; am. (2), Register, May,1990, No. 413, eff. 5−1−90; correction in (1) made under s. 13.93 (2m) (b) 7., Stats.,Register, May, 1990, No. 413, eff. 6−1−90; CR 14−002: r. and recr. Register July 2014No. 703, eff. 8−1−14.

N 2.02 Definitions. As used in this chapter:

(1) “Board” means board of nursing.

(2) “Board−approved school” means any of the following:

(a) A school in Wisconsin which has been approved by theboard or the board has granted authorization to admit studentsunder ch. N 1.

(b) A school which participates in the electronic applicationprocess.

(3) “Certificate of approval” means the verification from aschool of nursing that the applicant has been approved to take theNCLEX prior to receiving a diploma in practical nursing or pro-fessional nursing.

(4) “Certificate of completion” means the verification from aschool of nursing that the applicant has completed the portion ofthe program equivalent to a diploma in practical nursing or profes-sional nursing.

(5) “Comparable school” means any of the following:

(a) A school holding nursing accreditation by a board−recog-nized nursing accreditation organization.

(b) A school located in the United States approved by the boardof nursing for that jurisdiction.

(c) A school located in a U.S. territory or a province of Canadawhich is approved by the board of nursing for that jurisdiction andmeets the standards of the Wisconsin board of nursing.

(6) “Department” means the department of safety and profes-sional services.

(7) “Direct supervision” means immediate availability tocoordinate, direct and inspect the practice of another.

(8) “LPN” means licensed practical nurse.

(9) “NCLEX” means national council licensure examination

(10) “RN” means registered nurse.History: Cr. Register, March, 1984, No. 339, eff. 4−1−84; renum. (1), (2), (4) to

(6) to be (2), (1), (5), (6) and (4) and am. (2), (4) and (5) am. (3), Register, May, 1990,No. 413, eff. 6−1−90; CR 01−049: am. (2), cr. (5m), Register October 2001 No. 550,eff. 11−1−01; correction in (3) made under s. 13.92 (4) (b) 6., Stats., Register Novem-ber 2011 No. 671; CR 14−002: r. and recr. Register July 2014 No. 703, eff. 8−1−14.

Subchapter II — Licensure By Examination

N 2.10 Qualifications for licensure. (1) REGISTERED

NURSE APPLICANTS. An applicant is eligible for licensure as a reg-istered nurse if the applicant complies with all of the followingrequirements:

(a) Graduates from a high school or its equivalent.

(b) Does not have an arrest or conviction record, subject to ss.111.321, 111.322 and 111.335, Stats.

(c) Graduates from any of the following:

1. A board−approved school of professional nursing.

2. A comparable school of professional nursing.

(d) In lieu of meeting the requirement in par. (c), evidence ofgeneral and professional educational qualifications comparable tothose required in this state at the time of graduation.

(e) Passes the NCLEX.

(2) LICENSED PRACTICAL NURSE APPLICANTS. An applicant iseligible for licensure if the applicant meets all of the followingrequirements:

(a) Completed two years of high school or its equivalent.

(b) Is 18 years or older.

(c) Does not have an arrest or conviction record, subject to ss.111.321, 111.322 and 111.335.

(d) Graduates from any of the following:

1. A board−approved school of practical nursing.

2. A comparable school of practical nursing.

(e) In lieu of meeting the requirement in par. (d), evidence ofgeneral and professional educational qualifications comparable tothose required in this state at the time of graduation.

(f) Passes the NCLEX.History: CR 14−002: cr. Register July 2014 No. 703, eff. 8−1−14; correction in

(2) (intro.) made under s. 35.17, Stats., Register July 2014 No. 703.

N 2.11 Application procedure for applicants fromboard−approved schools. (1) Each applicant from a board−approved school shall complete and submit an application by theelectronic application process or on forms provided by the depart-ment and shall pay the fee.

(2) The educational administrator or designee for a school ofprofessional nursing or practical nursing shall submit any of thefollowing:

(a) Via the electronic application process a verification that theapplicant has graduated or received a certificate of completion.

(b) A certification of graduation or completion to the depart-ment.

(3) (a) The examination accepted by the board is the NCLEX.

45

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https://docs.legis.wisconsin.gov/document/administrativecode/N%202.01


















https://docs.legis.wisconsin.gov/document/statutes/441.01(3)

https://docs.legis.wisconsin.gov/document/register/339/B/toc




https://docs.legis.wisconsin.gov/document/cr/2014/2



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https://docs.legis.wisconsin.gov/document/statutes/13.92(4)(b)6.

https://docs.legis.wisconsin.gov/document/register/671/b/toc







https://docs.legis.wisconsin.gov/document/administrativecode/N%202.10(1)(c)




https://docs.legis.wisconsin.gov/document/administrativecode/N%202.10(2)(d)





6 N 2.11 WISCONSIN ADMINISTRATIVE CODE

Published under s. 35.93, Wis. Stats., by the Legislative Reference Bureau.


is the date the chapter was last published.Register August 2016 No. 728

(b) The board shall notify the applicant of eligibility for admis-sion to the NCLEX once it receives verification of any of the fol-lowing:

1. Certificate of approval.

2. Graduation.

3. Certificate of completion.

(c) The applicant shall contact the examination provider toschedule the NCLEX date and time within one year from the timethe notice of eligibility is received by the applicant.

(d) The board shall send notification of results to applicantswho fail to earn a passing score on the NCLEX. An applicant mayapply to the board for authorization to schedule reexamination.The reexamination may not occur earlier than 45 days after themost recent sitting for the NCLEX.

(4) An applicant who has a pending criminal charge or hasbeen convicted of any crime or ordinance violation shall providethe board all related information necessary for the board to deter-mine whether the circumstances of the arrest or conviction orother offense substantially relate to the practice of nursing.

(5) An applicant who has committed any act, which would besubject to discipline under ch. N 7, shall provide the board withall related information regarding the act necessary for the boardto make a determination on the application for licensure.

History: CR 14−002: cr. Register July 2014 No. 703, eff. 8−1−14; correction to(3) (title) and renumbering (3) made under s. 13.92 (4) (b) 1. and 2., Stats., RegisterJuly 2014 No. 703.

N 2.12 Application procedure for applicants fromcomparable schools. (1) Each applicant from a comparableschool shall complete and submit an application on forms pro-vided by the department.

(2) The school of professional nursing or practical nursingshall forward directly to the department, official transcripts ofnursing education for applicants who graduated from the school.If the applicant graduated from a school of professional nursingor practical nursing from a U.S. territory or outside the UnitedStates, the applicant shall submit any of the following:

(a) For a professional nursing applicant, a valid certificateissued by the commission on graduates of foreign nursing schoolsor another board−approved entity which evaluates education.

(b) For a practical nursing applicant, a credential evaluationservice academic report and demonstration of passing a boardaccepted language proficiency exam.

(3) (a) The examination accepted by the board is the NCLEX.

(b) The board shall notify the applicant of eligibility for admis-sion to the NCLEX once it receives verification of any of the fol-lowing:

1. Certificate of approval.

2. Graduation.

(c) The applicant shall contact the examination provider toschedule the NCLEX date and time within one year from the timethe notice of eligibility is received by the applicant.

(d) The board shall send notification of results to applicantswho fail to earn a passing score on the NCLEX. An applicant mayapply to the board for authorization to schedule reexamination.The reexamination may not occur earlier than 45 days after themost recent sitting for the NCLEX.

(4) An applicant who has a pending criminal charge or hasbeen convicted of any crime or ordinance violation shall providethe board all related information necessary for the board to deter-mine whether the circumstances of the arrest or conviction orother offense substantially relate to the practice of nursing.

(5) An applicant who has committed any act, which would besubject to discipline under ch. N 7, shall provide the board with

all related information regarding the act necessary for the boardto make a determination on the application for licensure.

History: CR 14−002: cr. Register July 2014 No. 703, eff. 8−1−14; correctionto (3) (title) and renumbering (3) made under s. 13.92 (4) (b) 1. and 2., Stats., Reg-ister July 2014 No. 703.

Subchapter III — Licensure by Endorsement

N 2.20 Endorsement of an applicant from a nurselicensure compact state. (1) A current license from a statewhich has adopted the nurse licensure compact under s. 441.50,Stats., is considered to have met educational and other qualifica-tions comparable to those required in this state.

(2) An applicant from a nurse licensure compact state shallfile a completed application, declare Wisconsin as the primarystate of residence, and pay the applicable fee.

(3) An applicant who has a pending criminal charge or hasbeen convicted of any crime or ordinance violation shall providethe board with all related information necessary for the board todetermine whether the circumstances of the arrest or convictionor other offense substantially relates to the practice of nursing.

(4) An applicant who has committed any act, which would besubject to discipline under ch. N 7, shall provide the board withall related information regarding the act necessary for the boardto make a determination on the application for licensure.

(5) An applicant who has a nursing license encumbered byadverse action shall provide the board with all related informationnecessary to determine whether the board deems the action takento warrant a denial in Wisconsin. Any license issued to an appli-cant with an encumbered nursing license elsewhere shall be a sin-gle state license to practice in the state of Wisconsin.

History: CR 14−002: cr. Register July 2014 No. 703, eff. 8−1−14.

N 2.21 Endorsement of an applicant from anotherU.S. state, territory or Canada. (1) (a) A license from a U.S.state that has not adopted the nurse licensure compact under s.441.50, Stats., a U.S. territory or Canada is considered to have meteducational and other qualifications comparable to those requiredin this state provided the requirements of the initial licenseincluded all of the following:

1. Graduation from a school approved by the board in thejurisdiction of initial licensure or had education the board in thejurisdiction of initial licensure deemed to be comparable to aschool that board approves.

2. Passage of the NCLEX.

(b) An applicant, whose initial license from another U.S. state,territory or Canada does not meet the requirements in par. (a), shallsubmit all of the following to the board to assist the board in deter-mining whether the qualifications are comparable:

1. Evidence of educational qualifications.

2. Evidence of passing the NCLEX or other nursing licensureexamination.

(2) An applicant shall submit a completed application and paythe applicable fee. The application shall include the following:

(a) Verification of licensure from the state, territory or prov-ince in which the original license by examination was issued andthe state, territory or province in which the current, active licensewas issued.

(b) Documentation of employment history.

(c) An applicant who has a pending criminal charge or has beenconvicted of any crime or ordinance violation shall provide theboard with all related information necessary for the board to deter-mine whether the circumstances of the arrest or conviction orother offense substantially relate to the practice of nursing.

(d) An applicant who has a license encumbered by adverseaction shall provide the board will all related information neces-

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is the date the chapter was last published. Register August 2016 No. 728

sary to determine whether the board deems the action taken towarrant a denial in Wisconsin.

(e) An applicant who has been terminated from any employ-ment related to nursing shall provide the board with all relatedinformation necessary to determine current competency.

(f) An applicant who has committed any act, which would besubject to discipline under ch. N 7, shall provide the board withall related information regarding the act necessary for the boardto make a determination on the application for licensure.

(3) An applicant who does not have current nursing educationor been employed in a position that requires a nursing licensewithin the last 5 years may apply to the board for a limited licenseto enable the applicant to complete a nursing refresher courseapproved by the board. Upon successful completion of anapproved nursing refresher course, the license holder may petitionthe board for full licensure.


Subchapter IV — Temporary Permits

N 2.30 Definitions. In this subchapter:

(1) “G.N.” means graduate nurse.

(2) “G.P.N.” means graduate practical nurse.History: CR 14−002: cr. Register July 2014 No. 703, eff. 8−1−14.

N 2.31 Application. A nurse who has graduated from aboard−approved school or comparable school or granted a certifi-cate of completion by a board−approved school may be granteda temporary permit. An applicant shall submit a completed appli-cation and pay the applicable fee. The application shall includeany of the following:

(1) Verification from a board−approved school via the elec-tronic application process that the applicant has graduated orreceived a certificate of completion.

(2) A certification of graduation or completion from a board−approved school.

(3) An official transcript of nursing education submitted bythe school of professional nursing or practical nursing directly tothe department.


N 2.32 Title. (1) A registered nurse applicant for licensureby exam who is granted a temporary permit may use the title“graduate nurse” or the letters “G.N.”

(2) A practical nurse applicant for licensure by exam who isgranted a temporary permit may use the title “graduate practicalnurse” or the letters “G.P.N.”

(3) A registered nurse or practical nurse for licensure byendorsement who is granted a temporary permit may use the title“registered nurse” or “licensed practical nurse.”


N 2.33 Supervision. (1) Except as provided in sub. (2),the holder of a temporary permit shall practice only under thedirect supervision of a registered nurse.

(2) A holder of a temporary permit who is currently licensedas a registered nurse or practical nurse in another jurisdiction maypractice without the direct supervision of a registered nurse.


N 2.34 Duration. The temporary permit is valid for aperiod of 3 months or until the holder receives notification of fail-ing the NCLEX, whichever occurs first. Practice under temporarypermits, including renewals under s. N 2.35, may not exceed 6months total duration.


N 2.35 Renewal. (1) A temporary permit for a registerednurse or practical nurse may be renewed once by completing an

application, completing a nursing workforce survey and paymentof applicable fees.

(2) Subsequent renewals may be granted in hardship casesincluding illness, family illness or death, accident, natural disasteror delay of verification from another state. The board shall con-sider each application for renewal under this subsection individu-ally on its merits, and the board may grant a renewal as deemedappropriate.


N 2.36 Denial or revocation. A temporary permit may bedenied or revoked for the following:

(1) Providing fraudulent information on an application forlicensure.

(2) Misrepresentation of being an R.N., G.N., L.P.N. or G.P.N.without holding a valid temporary permit.

(3) Violation of any of the rules of conduct set forth in ch. N7.


Subchapter V — Renewal

N 2.40 Renewal. (1) GENERAL. A person with an expiredcredential may not reapply for a credential using the initial appli-cation process.

(2) RENEWAL WITHIN 5 YEARS. A person renewing the creden-tial within 5 years shall do all of the following:

(a) Pay the renewal fee as determined by the department unders. 440.03 (9) (a), Stats., and any applicable late renewal fee.

(b) Pay a nursing workforce survey fee.

(c) Complete the nursing workforce survey to the satisfactionof the board.

(3) RENEWAL AFTER 5 YEARS. This subsection does not applyto credential holders who have unmet disciplinary requirementsor whose credential has been surrendered or revoked. A personrenewing the credential after 5 years shall do all of the following:

(a) Pay the renewal fee as determined by the department unders. 440.03 (9) (a), Stats., and the late renewal fee.

(b) Pay a nursing workforce survey fee.

(c) Complete the nursing workforce survey to the satisfactionof the board.

(d) Meet one of the following requirements:

1. Documentation of employment requiring a nursing licensewithin the last five years.

2. Completion of a board approved nursing refresher courseor education equivalent to a nursing refresher course. A nursingrefresher course requires a limited license for the purpose of com-pleting the clinical component of the course.

Note: The licensee may request the Board grant a limited license for the sole pur-pose of completing a nurse refresher course.

History: CR 15−099: cr. Register August 2016 No. 728, eff. 9−1−16.

N 2.41 Reinstatement. A credential holder who hasunmet disciplinary requirements and failed to renew the creden-tial within 5 years or whose credential has been surrendered orrevoked may apply to have the credential reinstated in accordancewith all of the following:

(1) Evidence of completion of the requirements in s. N 2.40(3) if the license has not been active within 5 years.

(2) Evidence of completion of the disciplinary requirements,if applicable.

(3) Evidence of rehabilitation or change in circumstanceswarranting reinstatement.

(4) A revoked license may not be reinstated earlier than oneyear following revocation. This subsection does not apply to alicense that is revoked under s. 440.12, Stats.

History: CR 15−099: cr. Register August 2016 No. 728, eff. 9−1−16.

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is the date the chapter was last published. Register February 2012 No. 674

Chapter N 4

LICENSURE OF NURSE−MIDWIVES

N 4.01 Authority and intent.N 4.02 Definitions.N 4.03 Qualifications for licensure.N 4.04 Application procedures for licensure.N 4.05 Temporary permits.

N 4.06 Scope of practice.N 4.07 Limitations on the scope of practice.N 4.08 Licensure and exception.N 4.09 Health care facilities where practice shall occur.N 4.10 Malpractice insurance coverage.

Note: Chapter N 6 as it existed on September 30, 1985 was renumbered ChapterN 4, effective October 1, 1985.

N 4.01 Authority and intent. (1) The rules in this chap-ter are adopted pursuant to authority of ss. 15.08 (5), 227.11 and441.15, Stats.

(2) The intent of the board of nursing in adopting rules in thischapter, interpreting s. 441.15, Stats., is to specify the require-ments for obtaining licensure as a nurse−midwife; the scope ofpractice of nurse−midwifery; the types of facilities in which suchpractice may occur; and malpractice insurance requirements fornurse−midwives.

History: Cr. Register, December, 1981, No. 312, eff. 1−1−82; am. (2), Register,May, 1990, No. 413, eff. 6−1−90; correction in (1) made under s. 13.93 (2m) (b) 7.,Stats., Register, May, 1990, No. 413; CR 03−009: am (2), Register November 2003No. 575, eff 12−1−03.

N 4.02 Definitions. As used in this chapter:

(1) “Board” means board of nursing.

(2) “Bureau” means bureau of health service professionswithin the department of safety and professional services, locatedat 1400 East Washington Avenue, Madison, Wisconsin.

(2m) “Collaboration” has the meaning specified in s. 441.15(1) (a), Stats.

(4) “Complications” means those conditions which jeopar-dized the health or life of the patient and which deviate from nor-mal as defined in the written agreement consistent with the stan-dards of practice of the American College of Nurse−Midwives.

(5) “Direct supervision” means immediate availability to con-tinually coordinate, direct and inspect at first hand the practice ofanother.

(5m) “Nurse−midwife” means a nurse−midwife licensed bythe board.

(6) “Written agreement” means an agreement between thecollaborating physician and the nurse−midwife which is perma-nently recorded, dated and signed by both parties, is available forinspection upon reasonable request, and consists of at least the fol-lowing: framework of mutually approved guidelines includingconditions of collaboration and referral.

History: Cr. Register, December, 1981, No. 312, eff. 1−1−82; cr. (8), Register,September, 1985, No. 357, eff. 10−1−85; am. (2), (6) and (8), Register, May, 1990,No. 413, eff. 6−1−90; CR 03−009: renum. (3), (4) and (8) to be (4), (6) and (5) andam. (4) and (6), cr. (2m), r. (5) and (7), correction made under s. 13.93 (2m) (b) 1.,Stats., Register November 2003 No. 575; correction in (2) made under s. 13.92 (4)(b) 6., Stats., Register February 2012 No. 674.

N 4.03 Qualifications for licensure. An applicant forlicensure as a nurse−midwife shall be granted licensure by theboard, provided that the applicant meets all of the following:

(1) Has completed an educational program in nurse−mid-wifery accredited by the American College of Nurse−Midwives.

(2) Holds a certificate issued by the American College ofNurse−Midwives or the American College of Nurse−MidwivesCertification Council.

(3) Is currently licensed to practice as a professional nurse inWisconsin, or is currently licensed to practice professional nurs-

ing in another state which has adopted the nurse licensure com-pact.

History: Cr. Register, December, 1981, No. 312, eff, 1−1−82; am. (intro.) and (3),Register, May, 1990, No. 413, eff. 6−1−90; CR 01−046: am. (3), Register October2001 No. 550, eff. 11−1−01; CR 03−009: am. (intro.), (1) and (2) Register November2003 No. 575, eff. 12−1−2003.

N 4.04 Application procedures for licensure. (1) Anapplicant for licensure to practice as a nurse−midwife shall file acompleted, notarized application on a form provided by thebureau. The application shall include all of the following:

(a) Signature of the applicant.

(b) Fee specified under s. 440.05 (1), Stats.

(c) Evidence of completion of an educational program innurse−midwifery approved by the American College of Nurse−Midwives and evidence of certification as a nurse−midwife fromthe American College of Nurse−Midwives or the American Col-lege of Nurse−Midwives Certification Council.

(d) Identification of current licensure as a professional nursein Wisconsin or of current licensure in another state which hasadopted the nurse licensure compact, including the license num-ber and renewal information.

(2) A separate license shall be issued by the board for the prac-tice of nurse−midwifery.

(3) Renewal of a license to practice nurse−midwifery shall beconducted as a separate procedure from the renewal of the nurse’slicense as a professional nurse.

(4) The applicant for renewal shall inform the board whetherthe certificate issued to him or her by the American College ofNurse−Midwives or the American College of Nurse−MidwivesCertification Council has been revoked or suspended.

History: Cr. Register, December, 1981, No. 312, eff. 1−1−82; am. (1) (intro.), (c)and (d) and (3), Register, May, 1990, No. 413, eff. 6−1−90; CR 01−046: am. (1) (d)and (3), cr. (4), Register October 2001 No. 550, eff. 11−1−01; CR 03−009: am. (1)(intro.), (a) to (c) and (4) Register November 2003 No. 575, eff. 12−1−2003.

N 4.05 Temporary permits. (1) ELIGIBILITY. An appli-cant for licensure as a nurse−midwife who has completed an edu-cational program in nurse−midwifery approved by the Americancollege of nurse−midwives, who is currently licensed to practiceas a professional nurse in Wisconsin and who has paid the fee spe-cified in s. 440.05 (6), Stats., may be eligible for a temporary per-mit to practice nurse−midwifery.

(2) ISSUING A TEMPORARY PERMIT. The bureau of health ser-vice professions shall issue a temporary permit to an eligibleapplicant within one week of the determination of eligibility.

(3) SUPERVISION REQUIRED. The holder of a temporary permitshall practice under the direct supervision of a nurse−midwife cer-tified under s. 441.15, Stats., or a physician. The holder may notpractice beyond the scope of practice of a nurse−midwife as setforth in s. N 4.06.

(4) TITLE. The holder of a valid temporary permit under thissection may use the title “graduate nurse−midwife” or the letters“G.N.M.”.

(5) DURATION. (a) Except as provided in pars. (b) to (e), theduration of a temporary permit granted by the board is:

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https://docs.legis.wisconsin.gov/document/administrativecode/N%204.05(5)(b)

https://docs.legis.wisconsin.gov/document/administrativecode/N%204.05(5)(e)

12 N 4.05 WISCONSIN ADMINISTRATIVE CODE



is the date the chapter was last published.Register February 2012 No. 674

1. For applicants who have been granted a temporary permitto practice as a registered nurse, the period which coincides withthe registered nurse temporary permit.

2. For other applicants, 6 months.

(b) The temporary permit of a candidate who is unsuccessfulon the examination administered by the American College ofNurse−Midwives Certification Council is void upon receipt of theexamination results by the holder and shall be returned by theholder to the board immediately. Failure to return the permitpromptly shall, without further notice or process, result in a boardorder to revoke the permit.

(c) A temporary permit may be renewed once for a period of3 months.

(d) A second renewal for a 3−month period may be granted inhardship cases if an affidavit is filed with the board identifying thehardship. “Hardship cases”, as used in this paragraph, includes theinability to take or complete a scheduled examination because ofillness, family illness or death, accident or natural disaster orbecause the person is awaiting examination results.

(e) Practice under temporary permits, including renewalsunder pars. (c) and (d), may not exceed 12 months total duration.

(6) DENIAL. A temporary permit may be denied an applicantfor any of the reasons in sub. (7) for which the board may revokea temporary permit or for the misrepresentation of being a nurse−midwife or a graduate nurse−midwife before the granting of a per-mit under this section.

(7) REVOCATION. A temporary permit may, after notice andhearing, be revoked by the board for any of the following reasons:

(a) Violation of any of the rules of conduct for registered nursesin ch. N 7 or for violation of the rules governing nurse−midwivesunder ch. N 4.

(b) Failure to pay the required fees under s. 440.05 (6), Stats.

(c) Provision of fraudulent information on an application forlicensure.

History: Cr. Register, September, 1985, No. 357, eff. 10−1−85; r. and recr. (5) (a),am. (1) to (3) and (6), Register, May, 1990, No. 413, eff. 6−1−90; CR 03−009: am.(5) (b) Register November 2003 No. 575, eff. 12−1−2003.

N 4.06 Scope of practice. (1) The scope of practice isthe overall management of women’s health care, pregnancy,childbirth, postpartum care for newborns, family planning, andgynecological services consistent with the standards of practice ofthe American College of Nurse−Midwives and the education,training, and experience of the nurse−midwife.

(2) The nurse−midwife shall collaborate with a physician withpostgraduate training in obstetrics pursuant to a written agreementwith that physician.

(3) The nurse−midwife shall consult with the consulting phy-sician regarding any complications discovered by the nurse−mid-wife, or refer the patient pursuant to the written agreement.

(4) Upon referral, the nurse−midwife may manage that part ofthe care of the patient which is appropriate to the knowledge andskills of the nurse−midwife.

History: Cr. Register, December, 1981, No. 312, eff. 1−1−82; renum. from N.6.05, Register, September, 1985, No. 357, eff. 10−1−85; CR 03−009: am. RegisterNovember 2003 No. 575, eff. 12−1−2003.

N 4.07 Limitations on the scope of practice. (1) Thenurse−midwife shall not independently manage those complica-tions that require referral pursuant to the written agreement.

(2) The nurse−midwife may not perform deliveries by forcepsor Caesarean section. The nurse−midwife may use vacuumextractors only in emergency delivery situations.

(3) The nurse−midwife may not assume responsibilities,either by physician−delegation or otherwise, which he or she isnot competent to perform by education, training or experience.

(4) Following notification of a physician as required by s.441.15 (4), Stats., a nurse−midwife may continue to manage thedelivery when complications occur if emergency measures arerequired and the physician has not yet arrived.

History: Cr. Register, December, 1981, No. 312, eff. 1−1−82; renum. from N.6.06, Register, September, 1985, No. 357, eff. 10−1−85; CR 03−009: am. (1) and (2)Register November 2003 No. 575, eff. 12−1−2003.

N 4.08 Licensure and exception. (1) No person maypractice or attempt to practice nurse−midwifery or use the title orletters “Certified Nurse−Midwife” or “C.N.M.”, “Nurse−Mid-wife” or “N.M.”, or anything else to indicate that he or she is anurse−midwife unless he or she is licensed under this chapter.

(2) Nothing in this chapter shall be construed either to prohibitor to require a license under this chapter for any person lawfullypracticing professional nursing within the scope of a licensegranted under ch. 441, Stats.

History: Cr. Register, December, 1981, No. 312, eff. 1−1−82; renum. from N.6.07, Register, September, 1985, No. 357, eff. 10−1−85; am. Register, May, 1990, No.413, eff. 6−1−90.

N 4.09 Health care facilities where practice shalloccur. A health care facility where the practice of nurse−mid-wifery may occur is one that has adequate equipment and person-nel for conducting and monitoring the normal scope of practiceand that has available methods for referral to or communicationwith a higher level care facility if the need arises.

(2) Deliveries may be arranged for only in a facility which hasadequate sanitation, thermal regulation, staffing, communicationsystems and medical back−up.

(3) The above limitations do not apply to care given in emer-gency circumstances.

History: Cr. Register, December, 1981, No. 312, eff. 1−1−82; renum. from N.6.08, Register, September, 1985, No. 357, eff. 10−1−85.

N 4.10 Malpractice insurance coverage. (1) Nurse−midwives shall maintain in effect malpractice insurance evi-denced by one of the following:

(a) Personal liability coverage in the amounts specified in s.655.23 (4), Stats.

(b) Coverage under a group liability policy providing individ-ual coverage for the nurse−midwife in the amounts set forth in s.655.23 (4), Stats.

(2) Notwithstanding sub. (1), malpractice insurance is notrequired for any of the following:

(a) A federal, state, county, city, village or town employee whopractices nurse−midwifery within the scope of his or her employ-ment.

(b) A nurse−midwife who practices as an employee of the fed-eral public health service under 42 USC 233 (g).

(c) A nurse−midwife who does not provide care for patients.

(3) A nurse−midwife shall submit to the board satisfactoryevidence that he or she has in effect malpractice insurancerequired by sub. (1) at the time established for credential renewalunder s. 440.08 (2) (a) 50., Stats.

Note: Forms are available from the board office located at 1400 East WashingtonAvenue, P.O. Box 8935, Madison, Wisconsin 53708.

History: Emerg. cr. eff. 11−05−02; CR 03−009: cr., Register November 2003 No.575, eff. 12−1−2003.

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https://docs.legis.wisconsin.gov/document/administrativecode/N%204.05(5)(c)

https://docs.legis.wisconsin.gov/document/administrativecode/N%204.05(5)(d)



















https://docs.legis.wisconsin.gov/document/statutes/ch.%20441










https://docs.legis.wisconsin.gov/document/usc/42%20USC%20233


https://docs.legis.wisconsin.gov/document/statutes/440.08(2)(a)50.




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